Commentary | VOICES / A FORUM FOR COMMUNITY ISSUES

Closing Trauma Unit Would Be a Tragedy

October 16, 2004|Charles Klieman | Charles Klieman is a vascular surgeon and consultant at Martin Luther King Jr./Drew Medical Center.

It would be tragic if the Los Angeles County Board of Supervisors closes the trauma center at Martin Luther King Jr./Drew Medical Center.

It is the shining star of hospital services. It saves thousands of lives every year. Yes, it is very expensive and most patients are indigent and don't have insurance. But the supervisors don't have a cogent plan for what to do with all these patients.

King/Drew treats the largest number of penetrating wounds annually of any trauma center in the city, except for County-USC Medical Center. Approximately 45% of the traumas are gunshot wounds or stabbings. Now let's think about that fact for a minute. There is only so much blood in the body that can hemorrhage until the patient is dead. A gunshot victim does not have the luxury of riding through traffic looking for treatment in another ZIP Code. There is a golden hour in trauma, often only golden minutes, and that can be the difference between life and death.

The supervisors are not proposing to close a library. They are proposing to cut off the community's life support. The supervisors divided the service areas of county hospitals and decreased the number of trauma cases at King/Drew. They had hoped to cut the numbers from 2,400 to 1,200 a year. Their plan did not succeed. The numbers fell only to about 1,800 this year. You can decrease the service area all you want, but most of the traumas occur around the hospital, and many trauma patients are dropped off by friends and family, not by ambulance.

There are no satisfactory options for these patients other than the King/Drew trauma center. St. Francis Medical Center in Lynwood can only absorb a few additional traumas. California Hospital Medical Center in downtown L.A. has been proposed, but it is not yet an open and tested facility. County-owned Harbor-UCLA Medical Center near Torrance can accommodate some of these patients. A few serious injuries in any of these facilities and their trauma centers are closed until the patients clear out.

Why are the supervisors doing this? A simple answer is money, politics and frustration. Two years ago, the county was in a hum about not having enough money to support the expensive services at King/Drew. They cut some funding, and significant numbers of people were let go. Many services suffered by not having enough people to answer the phones, schedule patients for the clinic or surgery and take care of patients. Problems ensued. These incidents, however, had nothing to do with the trauma center.

The good news is that some incredible saves occur in the trauma center. This past weekend, two patients were saved who might not have survived transportation to another facility. One patient had a gunshot wound to his chest and required immediate removal of half of one lung to stop the hemorrhage. So what should be done to fix this problem? We need strong leadership within the hospital, in the community and from our elected officials. Closing King/Drew would have a domino effect, not just locally, but nationally. Closing the King/Drew trauma center is not an option.